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Objetivo Determinar el valor del índice nutricional pronóstico (INP) en la selección de pacientes para vigilancia activa (VA) en cáncer de próstata. Métodos Entre septiembre de 2020 y junio de 2022, se analizaron retrospectivamente los datos de 125 pacientes que se sometieron a prostatectomía laparoscópica asistida por robot. Todos los pacientes eran candidatos aptos para VA antes de la operación. Con base en los resultados patológicos obtenidos en la prostatectomía laparoscópica asistida por robot, los pacientes fueron asignados a 2 grupos. Los pacientes que cumplían con los criterios para VA se asignaron al grupo 1 y los demás se asignaron al grupo 2. Se compararon datos demográficos, valores de INP y parámetros hematológicos de los grupos. Resultados El 38% (n:48) de los pacientes cumplió los criterios del grupo 1 y el 62% (n:77) cumplió los criterios del grupo 2. Se encontró un incremento de grado y estadio (upgrade y upstage) en 76 (61%) y 26 (21%) pacientes, respectivamente. No hay diferencias significativas entre los grupos en cuanto a edad, IMC, PSA, densidad de PSA, volumen prostático y PI-RADS. El primer grupo obtuvo un valor de INP más alto. El valor de 49,45 se calculó mediante análisis ROC como el valor de corte ideal de INP para predecir la reclasificación a un grado y estadio más alto del cáncer de próstata (p<0,001). De acuerdo con el análisis de regresión tanto univariante como multivariante, se encontró que el INP era un predictor de exclusión de la VA (p<0,001). Conclusión Los incrementos de grado y estadio se detectan con mayor frecuencia en pacientes con valores bajos de INP. El uso del valor INP en la selección de pacientes para VA aumentará la tasa de éxito en la selección de los candidatos óptimos. (AU)

Objective To evaluate the importance of the Prognostic Nutritional Index(PNI) value for patient selection of active surveillance (AS) in prostate cancer. Methods Between September 2020 and June 2022, the data of 125-patients who underwent Robot-Assisted-Laparoscopic-Prostatectomy were retrospectively analyzed. All patients were suitable for AS preoperatively. Using the pathological results of Robot-Assisted-Laparoscopic-Prostatectomy, patients have been divided 2 groups. Patients who met the criteria for AS were defined as the first group, others were defined second. Demographic datas, PNI values and hematological parameters of the groups were compared. Results 38%(n:48) patients were found suitable for the group 1, and 62%(n:77) were found suitable for the group 2. Upgrading and upstaging were found at 76 patients (61%) and 26 (21%), respectively. There is no significant difference between groups on age, BMI, PSA, PSA-density, prostate volume, and PIRADS. PNI value was found higher at first group. The value of 49.45 was calculated by ROC analysis as the ideal PNI cut-off value for predicting upgrading and upstaging of prostate cancer(P<.001).According to the both univariate and multivariate regression analysis, PNI was found a predictor for exclusion from AS (P<.001). Conclusion Upgrading and upstaging are detected at a higher rate in patients with low PNI values. The use of PNI value in the selection of patients to AS will increase the success rate of ideal patient selection. (AU)

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OBJECTIVE: To evaluate the importance of the Prognotic Nutritional Index(PNI) value for patient selection of active surveillance(AS) in prostate cancer. METHODS: Between September 2020 and June 2022, the data of 125-patients who underwent Robot-Assisted-Laparoscopic-Prostatectomy(RALP) were retrospectively analyzed. All patients were suitable for AS preoperatively. Using the pathological results of RALP, patients have been divided two groups. Patients who met the criteria for AS were defined as the first group, others were defined second. Demographic datas, PNI values and hematological parameters of the groups were compared. RESULTS: 38% (n:48) patients were found suitable for the group1, and 62%(n:77) were found suitable for the group 2. Upgrading and upstaging were found at 76 patients (61%) and 26(21%), respectively. There is no significant difference between groups on age, BMI, PSA, PSA-density, prostate volume, and PIRADS. PNI value was found higher at first group. The value of 49.45 was calculated by ROC analysis as the ideal PNI cut-off value for predicting upgrading and upstaging of prostate cancer (P < ,001). According to the both univariate and multivariate regression analysis, PNI was found a predictor for exclusion from AS (P < ,001). CONCLUSION: Upgrading and upstaging are detected at a higher rate in patients with low PNI values. The use of PNI value in the selection of patients to AS will increase the success rate of ideal patient selection.

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INTRODUCTION: The skeletal muscle area (SMA) and prognostic nutritional index (PNI) are both considered as predictive parameters for mortality and morbidity for various type of cancer. In this study, we aimed to identify the effects of pre-operative SMA and PNI values on post-operative mortality and morbidity in patients with periampullary region tumors (PRT). METHODS: Patients between 2010 and 2020 were retrospectively analyzed and divided into two groups according to SMA and PNI cutoff values. Univariate and multivariate analysis was performed to find potential risk factors. RESULTS: The mean age was 65.94 ± 11.242 and 54 (60.6%) of the patients were male. Hypertension was found a reducing factor for morbidity in both univariate and multivariate analysis (p = 0.039; p = 0.045). Chronic obstructive pulmonary disease and low PNI were found as factors affecting mortality in univariate analysis (p = 0.046; p = 0.014). However, only low PNI was found as an enhancing factor for mortality in multivariate analysis. CONCLUSION: Although SMA is not a risk factor for post-operative morbidity and mortality, PNI can be considered as a risk factor for mortality in patients with PRT.

INTRODUCCIÓN: El área del músculo esquelético (SMA) y el índice nutricional pronóstico (PNI) se consideran parámetros predictivos de mortalidad y morbilidad para varios tipos de cáncer. En este estudio, nuestro objetivo fue identificar los efectos de los valores preoperatorios de SMA y PNI sobre la mortalidad postoperatoria. y morbilidad en pacientes con tumores de la región periampular (PRT). MÉTODOS: Los pacientes entre 2010-2020 fueron analizados retrospectivamente y divididos en dos grupos según los valores de corte de SMA y PNI. Se realizaron análisis univariados y multivariados para encontrar posibles factores de riesgo. RESULTADOS: La edad media fue de 65.94 ± 11.242 y 54 (60.6%) de los pacientes eran varones. Se encontró que la hipertensión es un factor reductor de la morbilidad tanto en el análisis univariado como en el multivariado (p = 0.039; p = 0.045). La EPOC y el PNI bajo se encontraron como factores que influyen en la mortalidad en el análisis univariante (p = 0.046; p = 0.014). Sin embargo, solo el PNI bajo se encontró como un factor potenciador de la mortalidad en el análisis multivariado. CONCLUSIÓN: Aunque la SMA no se consideró un factor de riesgo de morbilidad y mortalidad posoperatorias; La PNI puede considerarse un factor de riesgo de mortalidad en pacientes con PRT.

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Objetivo El objetivo del presente artículo fue identificar el valor pronóstico del índice nutricional pronóstico (INP) basal en pacientes con cáncer de próstata resistente a la castración metastásico (CPRCm) tratados con acetato de abiraterona o enzalutamida. Métodos Se incluyeron 101 pacientes de CPRCm. El INP se calculó mediante la fórmula 10×valor de albúmina sérica (g/dl)+0,005×recuento total de linfocitos (mm3). Se utilizó el análisis ROC para determinar el valor pronóstico del INP. Resultados El valor de corte estadísticamente significativo para el INP fue 46,62. La respuesta inicial del PSA y la cinética del PSA (respuesta precoz por PSA y respuesta por PSA del 30-50-90% en cualquier momento) fueron mucho mejores en el grupo INP>46,62 que en el grupo INP≤46,62 (p<0,01). En el análisis multivariante, el INP basal >46,62 fue un predictor independiente de la SLP por PSA (HR: 0,42; p<0,01), la SLP radiológica (HR: 0,53; p<0,01) y la SG (HR: 0,42; p<0,01). En el grupo de INP≤46,62, la mediana de la SG fue de 7,4 meses (IC 95%: 4,1-10,7) para el subgrupo de acetato de abiraterona frente a 17,6 meses (IC 95%: 10,1-25,1) para los subgrupos de enzalutamida (p<0,01). Conclusión El INP es un marcador pronóstico útil e independiente para los pacientes con CPRCm tratados con acetato de abiraterona o enzalutamida. El uso del INP previo al tratamiento puede ayudar a los médicos en la predicción de la supervivencia y en la elección de acetato de abiraterona o enzalutamida (AU)

Purpose We designed this study to identify the prognostic value of baseline prognostic nutritional index (PNI) in metastatic castration-resistant prostate cancer (mCRPC) patients treated with abiraterone acetate or enzalutamide. Methods One hundred one mCRPC patients were included. PNI was calculated using formula 10 × serum albumin value (g/dl)+.005 × total lymphocyte count (per mm3). ROC analysis was used for determining prognostic PNI value. Results The statistically significant cut-off value for PNI was 46.62. Initial PSA response and PSA kinetics (early PSA response and 30-50%-90% PSA response at any time) were much better in PNI>46.62 group than the PNI ≤46.62 group (P<.01). In multivariate analysis, baseline PNI level >46.62 was an independent predictor of PSA-PFS (HR: .42; P<.01), radiologic PFS (HR: .53; P<.01), and OS (HR: .42; P<.01). In the PNI≤46.62 group, median OS was 7.4 months (95% CI: 4.1-10.7) for the abiraterone acetate subgroup vs. 17.6 months (95% CI: 10.1-25.1) for enzalutamide subgroups (P<.01). Conclusion PNI is a useful, independent prognostic marker for mCRPC patients treated with either abiraterone acetate or enzalutamide. Using pre-treatment PNI may help clinicians in the prediction of survival and decision making based on abiraterone acetate or enzalutamide (AU)

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PURPOSE: We designed this study to identify the prognostic value of baseline prognostic nutritional index (PNI) in metastatic castration-resistant prostate cancer (mCRPC) patients treated with abiraterone acetate or enzalutamide. METHODS: 101 mCRPC patients were included. PNI was calculated using formula 10 x serum albumin value (gr/dL) + 0.005 × total lymphocyte count (per mm3). ROC analysis was used for determining prognostic PNI value. RESULTS: The statistically significant cut-off value for PNI was 46.62. Initial PSA response and PSA kinetics (early PSA response and 30 %-50%-90% PSA response at any time) were much better in PNI > 46.62 group than the PNI ≤ 46.62 group (p < 0.01). In multivariate analysis, baseline PNI level >46.62 was an independent predictor of PSA-PFS (HR: 0.42, p < 0.01), radiologic PFS (HR: 0.53, p < 0.01), and OS (HR: 0.42, p < 0.01). In the PNI ≤ 46.62 group, median OS was 7.4 months (95% CI: 4.1-10.7) for the abiraterone acetate subgroup vs. 17.6 months (95% CI: 10.1-25.1) for enzalutamide subgroups (p < 0.01). CONCLUSION: PNI is a useful, independent prognostic marker for mCRPC patients treated with either abiraterone acetate or enzalutamide. Using pre-treatment PNI may help clinicians in the prediction of survival and decision making based on abiraterone acetate or enzalutamide.

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